Records of 105 patients with central nervous system (CNS) lymphoma were analyzed in order to better define the incidence, setting, and management of CNS lymphoma and the role for CNS prophylaxis. Survival was best for patients under 30 years of age treated with whole-brain irradiation and intrathecal (IT) chemotherapy whose CNS involvement was an isolated event (median survival time, 1.8 years). Survival was worst for patients over 30 years of age whose CNS invasion occurred at a time of progressive systemic lymphoma (median time ten weeks if treated with whole-brain irradiation with or without IT chemotherapy). The risk of CNS invasion was greatest for those with lymphoblastic lymphoma. Among patients with Stage IIE, 111, or IV histiocytic lymphoma, the risk of CNS involvement was greatest for those with progressive or relapsing disease or involvement of the testes, peripheral blood, or epidural space of the spinal cord.
Cancer 49586-595, 1982.
HERE HAS RECENTLY BEEN considerable interest in T central nervous system (CNS) invasion by non-Hodgkin's lymphoma. This has paralleled our increasing success in the systemic management of this group of diseases. CNS involvement by lymphoma is a complication with high morbidity and mortality. It is not responsive to treatment with the standard chemotherapeutic agents used in lymphoma and its responsiveness to CNS irradiation and intrathecal chemotherapy has not been fully defined. Previous series have provided much useful information,' but have generally used older histopathologic classifications and had variable criteria for defining C N S lymphoma.'-3 The poor prognostic implications of CNS lymphoma have been emphasized,'-5 but it has been reported that patients whose CNS lymphoma is not associated with systemic pro-